1980, 06-04 Permit: 80-5391 GaragePLAN NUMBER —�
JOB ADDRI
1.
LOT BL
2.
OWNER `
3. Il,
AD S
CONT
4.
ADD
DESIGNER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
LEGAL DESCRIPTION — SEE ATTACHED
SUBDIVISION PARCEL NUMBER/S /(����5, L1+2, 0I,t 1 1
PHONE �- L l � xA_ — `'{ !J) ^ rc /'w M -D
ZIPActual Set Backs in Feet + , I
North South East West
P NE Size of Parcel Zone Classification
ZIP Ty eC St. O cup�ancy Sprinklered
❑Yes ❑No ❑ Req'd.
PHONE Val on Building Area in Sq. Ft.
5.
in 1:i�50C
�-
�ac� W
ADDRESS
ZIP
Mai�por
UpperFloorsGarage
Area L Storage
CHANGE OF USE FROM
TO
Area of Decks
Finished
BasementUnfin.
Basement
6.
TYPE
No. Baths
No. Stories
No. Rooms
No. of Dwellings
NEW ALT. AD'N. RPL. MVE.
❑ ❑ ❑ ❑
% OF WORK )Q BLD. ❑ PLMB. ❑ MECH. ❑ M.H. El ❑OTHER
CERTIFICATE
Req'd,
Rec'd
INot .
of EXEMPTION
d/
/
DESCRIBE WORK
Enum. Dist.
ocation Area)
Location,
8
FEES COLLECTED
VALUATION SOURCE GAS ELECTRIC WATER SEWER Ownership USE CODE
UTILOITIES Public ❑ rwate ❑
Single $
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
Building
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTION
Plumbing
DATE OF APPLICATION � �� l �S glC;NAT[JRF OF APPI ICANT ���
Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
NAME DATE Plan Check
��!
Env. H I I L'�) I i/' � I '>' `-`
SEPA
Planning
Fire Marshall Mobile Home
Co. Engineer Other (Specify)
Utilities TOTAL $jMCL
Plans Examiner
WHEN MACHINE VALIDAI
SEPA Checklist THIS BECOMES A PERMIT.
uil ing Tian r®} PERMIT IS NONTRANSFERABLE
PERMIT NUMI'ER
. 5;
537
0 04-8n
6,479.
IN THIS SPACE,
5'3 9,1 z
*86,00n -
lee
All
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